Benzodiazepine use and aggressive behaviour: A systematic review

Albrecht, Bonnie; Staiger, Petra K.; Hall, Kate; Miller, Peter; Best, David; Lubman, Dan I.

doi:10.1177/0004867414548902

Cited by 73 publications

(50 citation statements)

References 84 publications

(157 reference statements)

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“…It is notable that such patterns of use aligns with Australian data showing alprazolam and diazepam to be among the most widely prescribed (Islam et al, 2014) and misused (Nielsen et al, 2008;Stafford & Burns, 2012) benzodiazepines, and also the most widely studied in relation to exploring the benzodiazepine-aggression link (Albrecht et al, 2014).…”

Section: Main Analysessupporting

confidence: 68%

“…First, specific benzodiazepines are explored, allowing greater specificity than the majority of cross-sectional studies available. Second, the sample is relatively large, with an almost even gender split; the latter feature absent in a number of well-designed, though maleonly, examinations of benzodiazepine-related aggression (see Albrecht et al, 2014 for a review). Third, the response is explored through the application of a clear theoretical framework.…”

Section: Limitations and Strengthsmentioning

confidence: 99%

“…Yet, few human studies have examined potential contributory factors (i.e., dose, other substance use, psychological or intrapersonal factors, situation; see Albrecht et al, 2014, for systematic review). Of note, irrespective of a long-standing proposal that intrapersonal factors are important in understanding this response (Lion et al, 1975;Hoaken and Stewart, 2003), only a handful of studies have investigated the role of various personality characteristics in benzodiazepine-related aggression (i.e., trait anxiety, hostility; Wilkinson, 1985;Cherek et al, 1990;Ben-Porath and Taylor, 2002;Dåderman et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

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Motivational drive and alprazolam misuse: A recipe for aggression?

Albrecht

Staiger

Hall

et al. 2016

Psychiatry Research

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Benzodiazepine-related aggression is understudied in the literature, in particular little is known about the motivational factors which may contribute to the development of this paradoxical response. The revised Reinforcement Sensitivity Theory provides a theoretical framework from which to understand the relevant underlying motivational processes. The current study aimed to identify the role of approach and avoidance motivational tendencies in the occurrence of benzodiazepine-related aggression. Data regarding benzodiazepine and other substance use, approach and avoidance motivation, and general and physical aggressive behaviour were collected via self-report questionnaires. Participants were a convenience sample (n = 204) who reported using benzodiazepines in the previous year. Participants were primarily male (62.7%), aged 18-51 years old. Hierarchical multiple regressions indicated that general and physical aggression were predicted by alprazolam use and Drive, a facet of approach motivation. Overall, lower diazepam use significantly predicted higher levels of general aggression. However, when diazepam-preferring participants were examined in isolation of the larger sample (23.5% of sample), problematic (dependent) diazepam use was associated with greater aggression scores, as was dependence risk for alprazolam-preferring participants (39.7% of sample). The findings highlight the importance of motivational factors and benzodiazepine use patterns in understanding benzodiazepine-related aggression, with implications for violent offender rehabilitation.

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Section: Main Analysessupporting

confidence: 68%

Section: Limitations and Strengthsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Motivational drive and alprazolam misuse: A recipe for aggression?

Albrecht

Staiger

Hall

et al. 2016

Psychiatry Research

Self Cite

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“…That is, previous research has focused on community samples, clinical or substance using samples, or forensic samples in custodial settings (Albrecht et al, 2014), greatly reducing the applicability of the findings to community-based offenders. Furthermore, our data permitted specific examination of the roles of diazepam and alprazolam in violent offending.…”

Section: Limitations and Strengthsmentioning

confidence: 99%

“…Forensic samples (i.e., individuals progressing through various stages of the criminal justice system) have been found to misuse benzodiazepines more than the general community (Australian Institute of Health and Welfare, 2011;Ng & Macgregor, 2012). Yet, research investigating the relationship between benzodiazepine use and criminal behaviour is rare (Albrecht et al, 2014). Specifically, no studies have investigated the role of benzodiazepine use and violent crime in an adult community criminal justice sample.…”

Section: Introductionmentioning

confidence: 99%

Benzodiazepine use of community-based violent offenders: a preliminary investigation

Albrecht

Staiger

Best

et al. 2016

Journal of Substance Use

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Declarations of interestWe declare that none of the authors are in receipt of financial support, or have any relationship that may pose a conflict in relation to the content presented in the submitted manuscript. Dan Lubman has received speaking honorarium from AstraZeneca and Janssen, as well as provided consultancy advice to Lundbeck. Suzanne Nielsen is an investigator on untied educational grants from Reckitt Benckiser.BENZODIAZEPINES AND VIOLENT CRIME 3 Benzodiazepine use of community-based violent offenders: A preliminary investigation. Abstract Objective:To explore the relationship between benzodiazepine use and violent crime in a sample of community-based offenders. Methods:Participants were recruited via drug diversion and treatment programs in Melbourne, Australia. Data regarding benzodiazepine and other substance use, mental health, personality characteristics, and crime involvement was collected through semi-structured interviews conducted in 2011. Participants (n = 82, 79.3% male) were 21-56 years old, predominantly Australian-born (89%), with 14.6% identifying as Aboriginal or Torres Strait Islanders.Eligibility criteria were having been charged with a criminal offence in the previous six months and at least monthly benzodiazepine use. Group differences between violent (n = 11) and non-violent offenders were assessed via independent samples t-tests (two-tailed) and non-parametric tests. Results:Individuals charged with violent index offences were significantly more likely to use higher average doses of alprazolam (p = .040), and exhibit benzodiazepine dependence (p = .037) as well as report high levels of sensation seeking, prior violence, and the diagnoses of depression and personality disorder, than individuals charged with non-violent index offences. Conclusions:The findings suggest the existence of a complex dynamic between mental health and violent offending that may be influenced by benzodiazepine use, in particular alprazolam. A core BENZODIAZEPINES AND VIOLENT CRIME 4 implication of these preliminary findings includes attending to the interpersonal skills and adaptive coping resources of violent offenders.

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Pharmacological interventions for self-harm in adults

Hawton

Witt

Salisbury

et al. 2015

Cochrane Database of Systematic Reviews

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Given the low or very low quality of the available evidence, and the small number of trials identified, it is not possible to make firm conclusions regarding pharmacological interventions in SH patients. More and larger trials of pharmacotherapy are required. In view of an indication of positive benefit for flupenthixol in an early small trial of low quality, these might include evaluation of newer atypical antipsychotics. Further work should include evaluation of adverse effects of pharmacological agents. Other research could include evaluation of combined pharmacotherapy and psychological treatment.

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Benzodiazepine use and aggressive behaviour: A systematic review

Cited by 73 publications

References 84 publications

Motivational drive and alprazolam misuse: A recipe for aggression?

Motivational drive and alprazolam misuse: A recipe for aggression?

Benzodiazepine use of community-based violent offenders: a preliminary investigation

Pharmacological interventions for self-harm in adults

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